Nursing Elites

1. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?

• A. If the phenazopyridine upsets my stomach, I can take it with meals.
• B. The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection.
• C. I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin.
• D. I should notify my provider immediately if my urine turns an orange color.

Correct answer: D

Rationale: Phenazopyridine can turn the urine orange, which is a normal side effect and not a cause for alarm. The client's statement about notifying the provider immediately if their urine turns orange indicates a need for further teaching because it shows a misunderstanding of the medication's side effects. Choices A, B, and C demonstrate a good understanding of the prescribed medications and their effects, indicating the client has grasped the teaching provided on those aspects.

2. A client with rheumatoid arthritis is prescribed long-term prednisone therapy. What adverse effect should the client monitor for according to the nurse's instruction?

• A. Stress fractures
• B. Orthostatic hypotension
• C. Gingival ulcerations
• D. Weight loss

Correct answer: A

Rationale: The correct answer is A: Stress fractures. Long-term prednisone therapy can lead to osteoporosis, which increases the risk of stress fractures. Option B, orthostatic hypotension, is not a common adverse effect associated with prednisone use. Option C, gingival ulcerations, is more commonly associated with conditions like periodontal disease or poor oral hygiene rather than prednisone therapy. Option D, weight loss, is not a typical adverse effect of prednisone; in fact, weight gain is more common due to prednisone's impact on metabolism.

3. A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching?

• A. I will give my child a dose as soon as wheezing starts.
• B. My child should rinse out his mouth after using the inhaler.
• C. My child should exhale completely before placing the inhaler in his mouth.
• D. If my child has difficulty breathing in the dose, a spacer can be used.

Correct answer: A

Rationale: The correct answer is A. Cromolyn sodium is a preventive medication and should not be used as a rescue inhaler when wheezing starts. This indicates a need for further teaching as the parent should understand that cromolyn sodium is not meant for immediate relief of symptoms. Choice B is correct as rinsing the mouth after using the inhaler helps reduce the risk of oral thrush, a common side effect. Choice C is correct as exhaling completely before using the inhaler helps ensure proper inhalation of the medication. Choice D is correct as a spacer can be used if the child has difficulty coordinating breathing with the inhaler, improving medication delivery.

4. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

• A. Hearing examination
• B. Glucose tolerance test
• C. Electrocardiogram
• D. Pulmonary function tests

Correct answer: C

Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.

5. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority?

• A. Administer the medication to the client before breakfast in the morning.
• B. Assist the client to a chair before administering the medication.
• C. Give the medication to the client with water rather than milk.
• D. Educate the client on how to take the medication at home.

Correct answer: A

Rationale: The correct answer is to administer the medication to the client before breakfast in the morning. Alendronate should be taken on an empty stomach before breakfast to ensure optimal absorption. Choice B is incorrect because assisting the client to a chair is not directly related to the administration of alendronate. Choice C is incorrect as there is no specific requirement to avoid taking alendronate with milk. Choice D is also incorrect as the priority at this moment is the correct administration of the medication in the hospital setting.

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